FTLO Health Declaration Form | FTLO Travel
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Health
Declaration
Form

 

As your trip approaches, we will ask you to complete a Health Declaration Form which will be sent to you via email 72 hours before your trip. A SAMPLE form is provided below.

 

Health Declaration Form last updated 1/26/24.

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Health

Declaration Form

(SAMPLE)

1. I attest that I do not have symptoms of Covid or Influenza: *

I confirm that I am currently not experiencing any symptoms commonly associated with COVID-19 or Influenza, such as fever, cough, difficulty breathing, loss of taste or smell, or any other symptoms outlined by health authorities. I have not tested positive for COVID-19 within the past 14 days.

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2. I acknowledge the risk of contracting illness during travel: *

I understand that traveling involves potential exposure to various illnesses, including Covid and Influenza, and there is a heightened risk of contracting such illnesses during travel.

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3. I acknowledge the risks associated with group travel and, if I have booked a shared room, with shared accommodations:

​I understand that choosing to share accommodations with other travelers may involve inherent risks, including the potential for increased exposure to illnesses. I will take necessary precautions and follow any guidelines provided to minimize these risks.

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4. I acknowledge the risk of exposure to illness associated with group travel:

I understand that choosing to share transportation and accommodations with other travelers may involve inherent risks, including the potential for increased exposure to illnesses. I will take necessary precautions and follow any guidelines provided to minimize these risks.

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5. I agree to comply with local health and safety regulations: *

I understand that local health and safety regulations may vary at each destination we visit. I will familiarize myself with and comply with any specific guidelines or protocols provided by the trip organizers and local authorities to ensure the safety of myself and others.

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6. I will inform the trip leader of any changes in my health status: *

I commit to promptly informing the Trip Leader if there are any changes in my health status during the trip, including the development of Covid or Influenza symptoms. This will enable appropriate measures to be taken to safeguard the health of the group.

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7. I acknowledge my responsibility to protect the group from potential exposure if I develop any symptoms of illness.

This may involve wearing a mask, keeping a safe distance, and refraining from group activities if necessary.

 

8. By submitting this Health Declaration Form, I acknowledge that providing accurate information is crucial for the well-being of all travelers, our staff, and the communities we visit: *

I understand that failure to adhere to these guidelines may jeopardize the health and safety of others during the trip.

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Please Note: All prescribed medications should remain in their original containers with prescription labels attached. This will help eliminate questioning while traveling internationally and passing through customs and immigrations. Also, any life sustaining or life saving medications should be carried within the carry-on bag and not within checked luggage during air travel.

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